Abstract：
The current WHO classification of digestive system tumours (2019) has presented the concept of diagnostics of intraductal and cystic neoplasms of the pancreas mostly based on integrated molecular data and evaluations of their malignant potential. Intraductal pancreatic neoplasms with ductal phenotype include microscopic precursor lesions of pancreatic ductal adenocarcinoma - the pancreatic intraepithelial neoplasia and macroscopic precursor lesions of pancreatic cancer, where intraductal papillary mucinous neoplasm represents the most common neoplasm of the pancreas with cystic appearance. Both intraductal oncocytic papillary neoplasm and intraductal tubulopapillary neoplasm are now classified as separate entities associated with less aggressive subtypes of pancreatic carcinoma and better prognosis. Clinical significance of microscopic pancreatic intraepithelial neoplasias is limited, in contrast to other intraductal neoplasms, which are presented as cystic and/or solid tumours by imaging methods with important consequences for further treatment and indication of surgical therapy (resection versus \"watch and wait\" strategies). Neoplasms of nonductal origin, such as acinar cell carcinomas and neuroendocrine neoplasms, can uncommonly display an intraductal growth and their correct classification has a great clinical importance. Moreover, differential diagnostics of cystic pancreatic lesions include not only cystic and pseudocystically transformed neoplasms, but also a large spectrum of reactive, inflammatory and dysontogenetic cystic lesions.
摘要：
目前的WHO消化系统肿瘤分类（2019年）提出了胰腺导管内和囊性肿瘤的诊断概念，主要基于综合分子数据和对其恶性潜力的评估。具有导管表型的胰腺导管内肿瘤包括胰腺导管腺癌的微观前体病变-胰腺上皮内瘤变和胰腺癌的宏观前体病变，其中导管内乳头状黏液性肿瘤是胰腺最常见的囊性肿瘤。现在，导管内嗜酸细胞乳头状肿瘤和导管内肾小管乳头状肿瘤都被归类为与胰腺癌侵袭性较低的亚型和更好的预后相关的独立实体。微小胰腺上皮内瘤变的临床意义有限,与其他导管内肿瘤相比，通过影像学方法将其呈现为囊性和/或实体瘤，对进一步治疗和手术治疗的指征具有重要影响（切除与“观察并等待”策略）。非导管源性肿瘤，如腺泡细胞癌和神经内分泌肿瘤，可以罕见地显示导管内生长，其正确分类具有很大的临床意义。此外，囊性胰腺病变的鉴别诊断不仅包括囊性和假性转化肿瘤，但也有大量的反应，炎症性和发育不良性囊性病变。
